It is known to provide wound dressings composed of certain materials in the form of a three dimensional shape complementary to the shape of a body part. For example, GB 2357286 discloses a process for preparing a shaped polyurethane article for use as or in a wound dressing, for example, a glove dressing for a whole hand, in which a last having the desired three-dimensional shape is provided, an aqueous layer is applied over the last, a layer of an isocyanate-capped prepolymer is applied over the last to react with the aqueous layer and form a polyurethane foam layer, which is then stripped from the last.
WO 03/092755 describes wound dressings in the form of body-shaped components composed of body-shaped cellulosic fabric which has been carboxymethylated at the wound contacting surface. The body shaped component composed of a fabric comprising a cellulosic material is subjected to a carboxymethylation process to carboxymethylate the cellulosic material at the wound-contacting surface. Prior to this disclosure it had not been suggested to provide body-shaped wound dressings incorporating a carboxymethylated cellulosic fabric. This may well have been because it can be difficult to create a body-shaped wound dressing from carboxymethylated cellulosic fiber because of the inherent weakness of such fiber which may preclude normal knitting into body shaped format such as gloves, and because of the need to keep the fiber dry during processing to stop it from absorbing moisture and becoming sticky.
Burns in difficult to dress areas such as the face, hands and upper torso are currently treated in a variety of ways which do not provide an ideal solution to the special problems presented by such wounds. For example, a burn to the hand is generally treated by covering the hand in antibacterial cream and putting it in a plastic bag secured around the wrist with a bandage and tape. Such treatment allows the patient to move the fingers freely but has the disadvantages that exudate from the wound collects in the bag which looks unsightly and may become heavy, dragging across the burn surface and making mobilization difficult. The skin on the hand also becomes very macerated making the wound difficult to assess.
Burns on the face are generally treated using dressings which are flat but flexible. The difficulty arises in maintaining contact between the wound and the dressing in a highly contoured area such as the nose, cheek or chin. Taping of the dressing is not always possible especially where the intact skin is fragile and secondary dressing with, for instance, a bandage may not increase conformity with the wound. It may also be difficult to manage the exudate produced by the wound in such an area and pooling or strike through may occur.
Wounds to an extensive area such as the chest are presently treated using many overlapping patch type dressings which are difficult to maintain in contact with the wound due to the problems of fixation and contraction. Many wound dressings contract on the absorption of exudate and, hence, where it is not possible to cover the wound with one dressing, that contraction needs to be allowed for by overlapping the dressings. This then presents a problem in fixing the dressings and maintaining contact with the wound.